As the nation�s health care debate winds down and a vote on some kind of package is taken, the question remains: Who will be in charge of the lives of millions of Americans as they struggle to maintain their health?

Even many of those who have exposed the manipulations of the health care industry, and especially the health insurance companies, are saying that they would vote for what is on the table now, because �something is better than nothing.�

It would never come to that, Americans were told, because the Democrats had a �supermajority� in the U.S. Senate and a margin of some 75 votes in the U.S. House, and a Democrat sat in the White House. Because of this, we were told to expect real health care reform.

What do we have that is better than what existed before Corporate America pulled out all the stops and poured money into the tea pot that is Washington, D.C.?

Let�s see. Insurance companies will not be able to drop you from coverage because you get sick. You will not be denied coverage if you have a pre-existing condition. You can keep your insurance plan, if you like it.

For all of the months of diatribes against any form of universal health care and the most uncivil series of epithets that masqueraded as debate for the better part of a year, that�s not much. It�s a start, according to those willing to take something, rather than nothing.

Gone is the likelihood of curbing the rising costs of premiums for coverage (everyone will have to purchase health insurance, with the working poor getting a subsidy from the government if they can�t pay), gone is the possibility of curbing �administrative costs� of insurance companies, and gone is the likelihood that excessive pay and bonuses to health company executives will be reduced or eliminated.

Insurers will be able to charge the elderly and those with pre-existing conditions more for premiums, and there will be no cap on premiums.

Health insurance companies will stay firmly in the driver�s seat for the foreseeable future and, with millions of new customers who are required to buy insurance, they will rake in billions of dollars more each year. They will be able to afford to absorb the cost of actually providing health care to their policy-holders. They have ways of discouraging people from seeking health care and they will come up with many new schemes to do so, no doubt.

It has been clear for decades that the government is much more efficient at providing health care than the private companies. Medicare, for example, has about 4.5 percent of its budget allocated for administrative costs, while the insurance industry, generally, spends between 24 percent and 30 percent for administrative costs, presumably including its advertising budget, its high pay and bonuses for management, and other costs associated with the labyrinth of forms and companies required for billing and payment.

There has been little to no discussion of this kind of inefficiency on the part of private industry. But that kind of inefficiency is repeated over and over in any kind of project or program in which a private company is engaged by the government. It�s as if the government - the people - have the deepest of pockets and whatever the final cost, the government will pay. That is, the people will pay it - through their taxes.

It has been a long time since there was any kind of discussion of this kind of plunder of the public treasury. It�s a �given� that government is inefficient. The people believe that because they have been so propagandized, by and on behalf of corporations using their own tax money to do it.

Many politicians have been carriers of this propaganda, some of them knowing full well that what they were saying was not true. In the health care reform �debate,� it has been Republicans who have refused to participate, but some Democrats have willingly participated in the flim-flam. Few of them are being held to account. One Democrat who has sided with the position of Republicans, Senator Blanche Lincoln of Arkansas, is facing a primary by a more liberal member of her own party. But that�s rare.

The press has been absent in any real coverage, creating headlines of the name-calling and the screaming rallies, especially in covering such as the Tea Party movement, whose members have said things and carried signs that could barely hide their racially-charged comments about Barack Obama and �his health care reform.� In their political ignorance, they even said he was a socialist.

By now, most Americans have heard that virtually every �developed� nation in the world has some form of universal health coverage for their citizens. At this time, America doesn�t need to stand out in this way - being just ahead of some �developing� nations in infant mortality and life expectancy.

The question that needs to be asked over and over is: Why are so many politicians and even some of the people opposed to providing health care for all? So far, there is no answer. The press is not asking the question.

When George W. Bush, as a sitting president, was asked the question, his answer was telling. He responded that we have virtual universal health care, since no one can be turned away from an emergency room, a visit for which we all pay.

Where was the press asking the follow-up question: �If someone turns up in the emergency room, saying �I have cancer,� what do you think the hospital is going to do?� It�s a simple question, but it never was asked. It�s one that needs to be asked over and over of the elected officials and politicians of every stripe.

The question of universal health care is a moral question. The answer tells us what kind of nation and society we are. It�s nothing less than the parable of the good Samaritan. It�s probably nothing more than that. When we see a fellow human being in need, what do we do as individuals? What do we do as a nation? The answers tell us who we are.

This is not a question of money. Already, we spend about double that of other countries, per capita, for health care, yet we have 47 million without access to health care and an equal amount with inadequate coverage. So, it�s not the money. With a more sensible health care system, we could save that amount and provide care for those who are without it today. Where does the money go?

This is not a question of public or private, although Medicare seems, hands down, the most efficient at delivering health care. According to T.R. Reid, author of The Healing of America, Japan has some 30 private payers in their universal health care system, but their costs are much less than the U.S. Other countries have a government-payer system and they work much more efficiently.

The one thing that distinguishes the U.S. from the other countries is that this is a for-profit system and, in Corporate America - which health insurance companies are solidly a part of - the bottom line, profits, are the main reason for existing.

No one should be surprised that a for-profit system concentrates on making a profit for its shareholders, rather than on the health of everyone in America. We�re rapidly coming to the point at which we are going to look around and find that who we are is a nation which overwhelmingly accepts the quest for profit over the health of the people.

A nation so constituted can not long keep up the charade of equality, liberty, and opportunity for all.

BlackCommentator.com Columnist, John Funiciello, is a labor organizer and former union organizer. His union work started when he became a local president of The Newspaper Guild in the early 1970s. He was a reporter for 14 years for newspapers in New York State. In addition to labor work, he is organizing family farmers as they struggle to stay on the land under enormous pressure from factory food producers and land developers. Click here to contact Mr. Funiciello.